Azocar 2003.

Methods	Study design: RCT Unit of allocation: physicians Type of comparison: PEM only vs. nothing group A: no dissemination group B: target dissemination group C: general dissemination Groups considered in review: A and B
Participants	Psychologists, psychiatrists, Master's‐level therapists Clinical speciality: psychiatry and psychology Level of training: fully trained Setting/country: not clear/US
Interventions	The PEM consisted of the UBH best practice guidelines for the treatment of major depression compiled from guidelines from both the American Psychiatric Association and the Agency for Health Care Policy and Research as well as current research. The UBH guidelines consist of a 1‐page quick reference and an 8‐page reference booklet and recommend basic steps in the assessment and treatment of major depression. The PEM was mailed to the intervention group of providers (n = 132), specifically targeting a patient recently referred with a diagnosis of major depression
Outcomes	4 process outcomes: guideline adherence (number of medication and psychotherapy sessions in outpatient care) guideline adherence (continuation of treatment, i.e. more than 180 days of treatment) guideline adherence (documentation of a mental health or substance abuse comorbidity) guideline adherence (documentation of medical condition inducing depression)
Notes	‐
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote (2001 article), pg. 1015: "simple randomization was used"
Allocation concealment (selection bias)	Unclear risk	Quote (2001 article), pg. 1015: "simple randomization was used"
Baseline characteristics similar (selection bias)	Low risk	Quote (2001 article), pg. 1015: "the type of license was controlled for in all group comparisons because it was somewhat confounded by group assignment"
Baseline outcome measurements similar (selection bias)	Unclear risk	No information was provided
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Quote (2003 article), pg. 115: "in addition, patient noncompliance with treatment recommendations and patient dropout was not measured, yet they are factors that can significantly influence treatment length and efficiency. Furthermore, services provided but not billed to UBH such as medication management by primary care physicians could not be accounted for" COMMENT: Not enough information is provided on drop‐out rates in each group and on reasons for dropping out
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Quote (2003 article), pg. 113: "guideline adherence was measured objectively using submitted claims and treatment plans provided by the clinicians"
Contamination protection (contamination bias)	Unclear risk	Quote (2003 article), pg. 1015: "simple randomization was used to give each clinician an equal chance of being assigned to each of the three groups…" COMMENT: professionals may have been allocated within a clinic or practice and it is possible that communication between intervention and control professionals could have occurred
Selective reporting (reporting bias)	Low risk	All relevant outcomes in the methods section were reported in the results section
Other bias	High risk	Quote (2003 article), pg. 115: "the small number of sessions delivered by study clinicians could have been due to the overrepresentation of psychiatrists in the sample and their delivering primarily monthly medication management services, rather than weekly psychotherapy", and "Furthermore, services provided but not billed to UBH such as medication management by primary care physicians could not be accounted for"